Human heart cells can be isolated from biopsy and autopsy material. These cells will, however, not be suitable for myocardial tissue engineering given their limited number, lack of cell cycle activity, and inability to reestablish a functional syncytium once they have been dispersed into single-cell suspensions. Consequently, cardiogenic stem cells will have to be exploited. Adult stem cells from the bone marrow do not harbor the capacity to generate the substantial amount of myocytes needed for complex myocardial reconstitution [
3,
35,
37]. In contrast, embryonic stem cells can, in principle, provide cardiomyocytes in adequate numbers [
55]. In addition, embryonic stem-cell-derived myocytes are still capable of developing into complex functional syncytia [
20] and, only recently, the use of embryonic stem-cell-derived cardiomyocytes was demonstrated in myocardial tissue engineering [
6,
17]. Collectively, these data provide strong evidence that embryonic stem cells might be an appropriate cell source for clinical-scale myocardial tissue engineering. However, cardiomyocyte yield from embryonic stem cells is generally low (1–5%; [
23]) and scalability will, consequently, be an important issue to generate relevant cardiomyocyte numbers and eventually “force-generating” human myocardium. The later goal has, despite two recent reports using embryonic stem-cell-derived myocytes in a 3D culture format [
6,
45], not been achieved, but it is likely that hydrogel-cultures will be instrumental to generate such tissues [
60]. Similarly, nonembryonic pluripotent stem cells, including induced pluripotent stem cells [
49], spermatogonial stem cells [
16], and parthenogenetic stem cells [
51], will be exploitable in cardiac tissue engineering. These cell types will, on the one hand, not require cell harvest from an early embryo and might, in addition, be suitable for the generation of autologous cells; however, other ethically controversial issues remain, including the need for genetic manipulations in the induced pluripotent stem-cell-based technology and the risk of in vitro mutagenesis and teratoma formation after an in vivo application.